Could a sales tax save Denver Health?

Hi there, Colorado, welcome to another edition of The Temperature, where this week we bring you news of a new fish highway, a new place to recharge your car while recharging your soul and … a vitally important safety net hospital that says it needs a tax measure to pass next month or else.

Hey, two out of three for happy stories is pretty good for us!

So, the mountains finally have a chance for snow this weekend, while the Front Range will hopefully also get some moisture. Perfect weather to curl up on the couch under a blanket — and watch some SunFest panels.

We now have videos posted online of select panels from this year’s best symposium for passionate Colorado-lovers. (The hyphen is crucial there; look elsewhere if you are interested in videos for passionate Colorado lovers.)

Included in the list are Tamara Chuang’s mind-blowing panel on artificial intelligence, Jason Blevins’ talk with a pro skier about mental health, Jennifer Brown’s deep and compassionate discussion about immigration, two panels from our politics team looking ahead to the election, and Kyle Clark’s keynote address. In short, it’s like a deep watering for your brain.

To watch, click on over to the SunFest 2024 section of the Colorado Sun’s YouTube page.

Now let’s get to that news.

John Ingold

Reporter

TEMP CHECK

HEALTH

Can a tax measure help save Denver Health?

For decades, the annual balance sheets for Denver Health, the city’s safety-net hospital, have looked like a child’s drawing of the Rocky Mountains.

Up, down, up, down — jagged peaks and steep valleys.

An upswing followed an economic downturn. The passage of the Affordable Care Act and the expansion of Medicaid gave the health system a big boost, but the implementation of a new electronic medical record system led to a year of deep losses.

“Our finances over multiple years have been a little like a roller coaster, one year is OK, another year’s bad,” Denver Health CEO Donna Lynne said.

But then came the COVID-19 pandemic. Emergency funding in 2020 pushed the hospital’s profit margin from operations to record heights. But in 2022, inflation, higher staffing costs and fundamental shifts in the insurance market smushed Denver Health’s margins into the deepest hole in over two decades.

The hospital lost around $32 million on operations in 2022. It turned a roughly $9 million profit in 2023, but one-time boosts from the state legislature and Kaiser Permanente contributed to that. This year, Denver Health expects to lose about $8.5 million, and as of June, the hospital had just a little over two months’ worth of cash-on-hand. (Best-practice standards usually call for around six months or more.)

In other words, it’s sinking. So it is asking Denver voters to throw it a lifeline.

Denver ballot measure 2Q would raise the city’s sales tax 0.34% — that’s 34 cents on a $10 purchase — to fund the hospital. The proceeds, if passed, are estimated to be around $70 million per year to start.

That would help Denver Health build up a cushion, but it still wouldn’t be enough to wipe out one of the hospital’s biggest reasons for struggling — the amount of care it provides but doesn’t get paid for as a safety-net hospital.

Also known as uncompensated care, the figure is estimated to hit $155 million for 2024, Lynne said, compared with $60 million in 2020.

About half of what Denver Health counts as uncompensated care is tied to Medicare and Medicaid patients — both programs pay less than what it costs Denver Health to provide care, so the hospital includes the shortfall in its total for uncompensated care.

The other half is tied to uninsured patients. That includes recent immigrants, though they are not a significant driver of losses for Denver Health. Lynne said uncompensated care for newcomers accounts for about $10 million of this year’s $155 million in uncompensated care.

These circumstances — more uninsured patients and rising losses from treating Medicare and Medicaid patients — are something being felt across the health care system. But unlike other hospitals, Denver Health doesn’t have a big pool of privately insured patients it can charge more to in order to offset those losses.

Lynne said about 14% of the hospital’s patients are privately insured. For other health systems in the Denver metro area, that percentage is typically closer to 30%.

On top of that, Lynne said it is common for medical providers to refer uninsured patients to Denver Health for follow-up care, meaning the hospital, while proud of its commitment to treating anyone and everyone, sits at the bottom of a large funnel of patients it won’t get paid to treat — and not just from Denver. Lynne said the hospital sees patients from 62 of Colorado’s 64 counties.

“We provide care across the state, and it’s one of my arguments with the state as to why they ought to support us financially,” Lynne said.

But large-scale state funding — or regional funding, or more funding from the city of Denver — has been a difficult ask. So Denver Health is turning directly to voters.

If that measure doesn’t pass, Lynne said Denver Health will look at making cuts to its services, which includes the main hospital, but also a number of community and school-based clinics, focused especially on underserved neighborhoods and communities in Denver.

“If it doesn’t pass, we will shrink services. We will cut services,” Lynne said. “We’ll have to get smaller to get better.”

You can read more in a comprehensive ballot measure explainer in the coming days on ColoradoSun.com.

And you can find all our ballot explainers in our 2024 voter guide here.

Section by John Ingold | Reporter

MORE HEALTH NEWS

• Homeless camp sweeps don’t cut crime, says a new study of 300 Denver cleanups. Researchers at the University of Colorado Anschutz Medical Campus looked at reports of crimes in close proximity to homeless camps before and after city officials swept those camps. They found at most a small, temporary reduction in crime in the immediate area around the swept camps. The reduction amounted to about one less crime report per week and it lasted only a couple of weeks. As Jennifer Brown writes, this research is significant because it assesses one of the main arguments city officials have used in justifying the sweeps, which advocates for people who are homeless say threaten the health of those living in the camps.
  — The Colorado Sun
• Colorado’s fund for opioid reversal naloxone is drying up, even as settlement money rolls in. For several years, Colorado’s legislature has been putting money into a fund to provide free naloxone — the opioid overdose-reversing drug — to organizations seeking to combat drug deaths in their communities. But the money mostly came from pandemic-era federal funding sources that are going away. Now the fund needs to find a new source of dollars, and, as Claire Cleveland reports, it’s not clear where that will be.
  — KFF Health News
• Colorado’s hospitals are conserving IV fluids. Blame a hurricane. Flooding from Hurricane Helene severely damaged a plant in North Carolina that produces bags of IV fluids — bags that had accounted for as much as 60% of the nation’s IV fluid supply. Now hospitals in Colorado, and in other states, are trying to cut back on use of IV fluids by using smaller bags or having patients hydrate orally if they are able to. No Colorado providers have reported canceling or postponing procedures, though.
  — The Denver Post
• Health insurance costs for people working at large companies are expected to take a big jump next year. In a recent survey, large, self-insured employers said they expect their medical costs to jump 8% next year unless they make changes to their coverage options. That’s the highest growth rate in a decade, and it has both employers and employees thinking about how to make coverage changes that save money.
  — The Associated Press

CLIMATE

Cutting the ribbon to reconnect one of the world’s most important rivers

With a snip of the ribbon, one of Colorado’s largest projects to help fish navigate the Colorado River was officially operational as of Tuesday.

The project, called the Colorado River Connectivity Channel, is part of Northern Water Conservancy District’s multimillion-dollar plan to shrink a West Slope reservoir, connect the river, help the environment, create a new Front Range reservoir, provide for growing communities and offer some new fishing and hiking spots along the way.

“It speaks to the new reality of working on water projects, which is that it doesn’t have to be an us versus them,” said Northern Water spokesperson Jeff Stahla. “People can get together and identify things that can help not only the water supply, but also help the environment.”

For four decades, the Colorado River has been broken by a dam and Windy Gap Reservoir in Grand County. The reservoir was designed to deliver an average of 48,000 acre-feet of water per year through numerous reservoirs, canals and pipelines to faucets in homes and sprinklers on farms across northeastern Colorado.

But it has also posed a problem for fish passage, aquatic ecosystems and the movement of sediment downriver. In 2021, Northern Water Conservancy District and its partners set out to cut Windy Gap in half and dig a channel around the reservoir.

Water has been flowing through the channel for about a year, and they’re already seeing benefits, Stahla said. One species of fish, a sculpin, has been detected in that stretch for the first time in 20 years.

About 150 people gathered Tuesday to celebrate the last piece of the project, a new diversion headgate, which was completed last week. The new gate will help manage the amount of water entering the reservoir and the channel.

After years of work, it was emotional for people to see water flowing past the reservoir, knowing that fish are already using that channel, Stahla said.

The connectivity channel, which cost $30 million, is part of an effort to provide stable water storage for growing Front Range communities and to fix a problem with Windy Gap that water providers have been working around since the reservoir was created in the 1980s.

Read more this week on what’s happening at Windy Gap at ColoradoSun.com.

Section by Shannon Mullane | Water Reporter

Public EV chargers make it to Steamboat Lake State Park

Colorado’s plan to get fast EV chargers at every state park took another populist jump this week with the hookup of two new Rivian Level 2’s at Steamboat Lake State Park.

Electric pickup and SUV maker Rivian worked on an agreement with Colorado Parks and Wildlife in 2021 to pay for installation of Rivian-branded chargers across the state facilities.

State parks officials were not available Tuesday to provide a full list of the parks where Level 2 chargers are finished, three years later. And unfortunately the state parks website doesn’t easily reveal the answer, even on the individual web pages of metro area parks where finished chargers have already been announced.

But the percentage of Steamboat Lake’s hundreds of thousands of visitors arriving by EV is ratcheting up along with state EV sales, and range anxiety continues to be one of the top consumer concerns while car shopping. The Rivian chargers at state parks can deliver about 25 miles of charge per hour, better than Level 1 home chargers but not as fast as Level 3 DC chargers increasingly found along the Front Range and interstate highways.

The Steamboat Lake chargers will be free “for a limited time,” Colorado Parks and Wildlife said.

Section by Michael Booth | Reporter

MORE CLIMATE NEWS

• Why they’re cutting down your favorite (dead) trees at Chatfield. Anglers and paddleboarders have grown to love the flooded thickets of cottonwood and willow offshore of rising Chatfield State Park reservoir. But now they have to say goodbye. Contractors will cut down and take away nearly 3,000 trunks under a long-planned mitigation effort, starting this week. But the future is bright — state officials report they’ve already planted 100,000 replacement trees and shrubs since 2018.
• State officials give up trying to find 5th wolf pup. Colorado wildlife officials have given up on capturing a fifth wolf pup that was left behind in Grand County when the rest of its pack was relocated last month. The operation to find the pup was suspended because of declining temperatures that make it unsafe to move the animal, Jennifer Brown reports. Wildlife officials saw the gray wolf pup on game cameras in September and tried for 19 nights to capture the pup, which they believe is the seventh member of the Copper Creek pack.
• State energy officials finalize “cumulative impact” rules. Colorado oil and gas regulators Tuesday passed sweeping rules to deal with the cumulative impacts of drilling and hailed it as “a big step forward,” but legislators, environmentalists and community groups criticized the regulations for failing to protect vulnerable communities. Mark Jaffe reports that after a year of hearings and drafts, the Colorado Energy and Carbon Management Commission adopted about 60 pages of rules to assess and mitigate the impacts of oil and gas drilling projects — an exercise mandated by the legislature.
• Trick question: How long does a 100-year aquifer last?  The state long ago adopted a “sip slowly” policy for the cities sucking water out of underground pools with a finite life. But with Front Range cities like Parker and Castle Rock growing even faster, they changed the rules to force even smaller annual sips for fear the aquifers would run out. Like all important Colorado water disputes, this one ended up in court, Jerd Smith writes.

CHART OF THE WEEK

Colorado’s sinking measles vax rate

This year has seen a smattering of measles cases across the country, part of a resurgence in the United States of the potentially deadly disease — which was once eradicated here.

Colorado hasn’t seen a measles case in 2024, though we did have one last year, the first in five years. But school vaccination rates show that some areas of the state could be particularly primed for an outbreak should a case of measles pop up there.

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Overall, the percentage of schoolkids in kindergarten through 12th grade who were fully vaccinated against measles last year hit its lowest level in at least six years. In the 2023-24 school year, 93.7% of students had received a full course of the MMR vaccine, meaning they were immunized against measles and two other diseases, mumps and rubella.

That may sound like a lot, but it is below the target level for achieving herd immunity. Because measles is so contagious, health experts say 95% vaccination coverage is needed to ensure the disease can’t spread within a community.

As the map above shows, some school districts in Colorado are quite a bit below that.

The lowest MMR vaccination rate in Colorado, in Moffat Consolidated School District #2, is 59.8%. The district includes the community of Crestone, which has long had low pediatric vaccination rates. Last year, 36.6% of the district’s students had exemptions to vaccination requirements.

There were 94 school districts last year in Colorado with MMR vaccination rates below 95%, with nine of those having rates below 80%.

Check out rates for a variety of vaccines by district on the Colorado Department of Public Health and Environment’s website.

Section by John Ingold | Reporter

Hey, thanks for making it all the way to the end. Go ahead and dip into the Halloween candy early. If your kids catch you, just make up some story about a magical goblin who has to do a candy quality-control audit for state regulations. Your kids will get bored by “audit,” and if they don’t, you know what to do next — show them our SunFest videos! They’re our kind of people.

And you are always our kind of people. Thanks for hanging with us for another week.

— John & Michael

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